Incidence and Risk Factors for Dry Eye Disease (DED) following Ptosis Correction through Combined Bilateral Anterior Levator Advancement and Blepharoplasty
Author: Evita Muller
Base Hospital / Institution: The West of England Eye Unit, Royal Devon and Exeter Hospital (Wonford)
Abstract ID: 25-215
Purpose
To assess the incidence and risk factors for the development of dry eye disease (DED) following anterior approach levator advancement and blepharoplasty in a real-world setting, including patients with pre-existing DED and other known risk factors.
Methods
A retrospective analysis was conducted on 99 patients (median age 77 years) who underwent bilateral ptosis correction via levator advancement and blepharoplasty. Patient-reported dry eye symptoms, satisfaction, and objective findings, including eyelid measurements, ocular surface condition, and postoperative management, were analysed. Follow-up ranged from 4-12 months.
Results
Preoperative ocular surface assessment showed a normal ocular surface in 68 patients, while 31 patients exhibited objective signs of DED. Among patients with normal ocular surface preoperatively, 29.4% (n=20) developed postoperative DED while 48.4% (n=15) of patients with preoperative DED developed worsening dry eye symptoms. Patients with preoperative DED who experienced worsening symptoms postoperatively were typically older and had a higher incidence of blepharitis and complex ocular histories, including prior intraocular surgery and trauma. Notably, among patients with preoperative DED, those who did not experience worsening symptoms postoperatively (n=16) had a smaller average postoperative eyelid lift (2 mm) compared to those who experienced worsening (3.5 mm).
Conclusion
35.4% of patients developed new dry eye symptoms following ptosis correction, though this did not affect patient satisfaction (92.9%). The incidence of postoperative dry eye symptoms in this cohort was higher than previously reported in the literature due to the inclusion of patients with pre-existing risk factors. A greater postoperative eyelid lift was associated with increased likelihood of developing dry eye symptoms, suggesting that a higher degree of surgical correction may be a risk factor, particularly in patients with pre-existing DED. These findings have significant implications for patient counselling, surgical targets, and postoperative management in ptosis patients.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Philomena | McNamara | The West of England Eye Unit, Royal Devon and Exeter Hospital (Wonford) |
| Ioana | Pereni | The West of England Eye Unit, Royal Devon and Exeter Hospital (Wonford) |
